Although the prognostic value of nodal metastases in differentiated thyroid cancer remains controversial, it is of interest to evaluate and understand the different characteristics of predictive outcomes.A multicenter retrospective study was conducted in 215 untreated patients with differentiated thyroid cancer from July 1997 to July 2015 in 4 medical centers of Guangdong Province. A total of 107 patients with nodal metastases (group A) were compared to 108 patients without metastases (group B). The 5-year disease-free survival (DFS), overall survival (OS), and postoperative complications in both groups were calculated. Variables predictive of DFS and OS were evaluated in group A.The group A had lower 5-year DFS (69.16%, 11 months) and shorter median time of recurrence than those in group B (87.96%, 8.5 months, respectively, P < 0.001). The incidence of temporary hypoparathyroidism in group A is lower; whereas higher incidence of temporary unilateral vocal cord palsy, permanent hypoparathyroidism, permanent unilateral vocal cord palsy, and bilateral vocal cord palsy in group A were observed. Both univariate and multivariate analyses in group A revealed that age, pathological tumor node metastasis (pTNM) stage, and histology were related to DFS (P < 0.05); while pTNM stage and histology were related to OS only in univariate analyses.Positive nodal metastases have significant prognostic value in patients with differentiated thyroid cancer in Guangdong, China and primarily reduce DFS. Moreover, patients with positive nodal metastases who are >45 years and have higher pTNM stage or follicular histology tend to have poor prognosis. Selective lymph node dissection with appropriate postoperative treatment and frequent follow-up should be accorded to these vulnerable groups of patients.
Object: The aim of this study was to describe a familial dyslipidemia revealed by a corneal arch. Familial hypercholesterolemia is a rare and severe hereditary dyslipidemia with an exceptional homozygous form. He was a 43-year-old patient admitted with visual disturbance, xanthomatous papule and orange coloring at the level evolving for 5 years, no personal history of cardiovascular disease, having a family history of lipid disorders in siblings, as a cardiovascular risk factor: age over 50 and the male gender, normal cardio pulmonary examination, blood pressure at 120/80 mmhg, heart rate 78 bpm, in whom the ophthalmological examination shows a yellowish spot on the cornea (Figure 1). We report the case of familial dyslipidemia revealed by a corneal spot in Guinea. More recent studies increasingly suggest that it is much more widespread than previously thought: 1/200 to 1/400. Familial dyslipidemia is a rare and severe metabolic abnormality. It should be screened as early as possible like any other cardiovascular risk factor for atheroma to avoid the occurrence of a major cardiovascular event.
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